A study of risk factors for Pott’s disease

M. Katkar, Ajay Chandanwale, Shreyas Zad, Sandeep Deshpande, Vishal Anand Mangwalkar
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Abstract

Pott’s spine is caused by Mycobacterium tuberculosis, a slow growing gram-positive, acid-fast bacillus which becomes lodged in the bone via Batson’s venous plexus and lymphatic from primarily infected lung, lymph nodes, mediastinum and viscera, forming granulomatous inflammation and caseation necrosis. Pott's spine accounts for 2% of all cases of TB, 15% of extrapulmonary, and 50% of skeletal TB. The paradiscal, central, anterior subligamentous, and neural arch are the common vertebral lesions. Thoracic vertebrae are commonly affected followed by lumbar and cervical vertebrae. Predisposing factors for tuberculosis include poverty, overcrowding, illiteracy, malnutrition, alcoholism, drug abuse, diabetes mellitus, immunosuppressive treatment, and HIV infection. These are also predisposing factors for spinal tuberculosis. Older age, female gender, chronic peritoneal dialysis, household crowding and previous tuberculous infection were identified as risk factors for Pott’s spine. (10G) Additionally, vitamin D deficiency has been linked to an increased risk of spinal bone loss and an increased risk of spinal fractures in individuals with Pott’s spine. : To identify and evaluate the risk factors for Pott’s spine. : Present study was prospective in nature conducted among 441 patients of Pott’s spine. All patients fulfilling inclusion criteria and exclusion criteria were taken up for the study. Study was carried out over a period of 3 years. Serum Vitamin D was assessed.: Majority of the patients was in the age group of 41-50 years and most of them were male. In this study, we found that age, socioeconomic status, employment, presence of comorbidities and BMI(<18) were associated with increased risk of pott’s spine.: This cross-sectional study investigates 441 cases of intervertebral disc degeneration leading to disc bulge/protrusion/extrusion, focusing on demographic, socioeconomic, and health-related factors. The majority of cases (31.82%) occurred in individuals aged 41-50 years, with females accounting for a larger proportion (54.55%) than males. Religious demographics revealed a prevalence of Muslims (45.57%) and Hindus (42.17%), with bilateral involvement common. A substantial portion of patients resided in slum areas (60.09%), reflecting socioeconomic disparities, with the majority (60.31%) belonging to the lower socioeconomic status. Most patients reported symptoms lasting less than 6 months (61.36%) and came from families with 5 or more members (85.48%). Addiction history (78.45%) and pre-existing co-morbidities (65.75%) were prevalent. Notably, no significant associations were found between serum Vitamin D levels and demographic factors. Among the employed, a significant proportion were unemployed (31.97%), underscoring socioeconomic challenges. These findings provide comprehensive insights into the multifaceted nature of intervertebral disc degeneration, crucial for informing targeted interventions and management strategies.
波特氏病风险因素研究
波特氏脊椎病是由结核分枝杆菌引起的,结核分枝杆菌是一种生长缓慢的革兰氏阳性耐酸杆菌,通过巴特森静脉丛和淋巴从主要受感染的肺、淋巴结、纵隔和内脏进入骨骼,形成肉芽肿性炎症和酪质坏死。波特氏脊椎结核占所有结核病例的 2%,占肺外结核的 15%,占骨骼结核的 50%。常见的椎体病变有椎旁、中央、韧带前下和神经弓。胸椎常见,腰椎和颈椎次之。结核病的诱发因素包括贫困、拥挤、文盲、营养不良、酗酒、滥用药物、糖尿病、免疫抑制治疗和艾滋病毒感染。这些也是脊柱结核的易感因素。高龄、女性、长期腹膜透析、家庭拥挤和既往结核感染被认为是波特氏脊柱的危险因素。(10G)此外,维生素 D 缺乏也与帕特氏脊柱炎患者脊柱骨质流失和脊柱骨折风险增加有关。 研究目的:确定并评估帕特氏脊柱炎的风险因素。 研究对象:本研究为前瞻性研究,研究对象为 441 名帕特氏脊柱炎患者。所有符合纳入标准和排除标准的患者均被纳入研究。研究为期 3 年。对血清维生素 D 进行了评估:大多数患者的年龄在 41-50 岁之间,其中大部分为男性。在这项研究中,我们发现年龄、社会经济地位、就业、合并症和体重指数(<18)与帕特氏脊柱炎的发病风险增加有关:这项横断面研究调查了 441 例因椎间盘退变而导致椎间盘膨出/突出/脱出的病例,重点关注人口、社会经济和健康相关因素。大多数病例(31.82%)发生在 41-50 岁的人群中,女性所占比例(54.55%)高于男性。宗教人口统计学显示,穆斯林(45.57%)和印度教徒(42.17%)占多数,双侧受累很常见。大部分患者居住在贫民区(60.09%),这反映了社会经济差异,其中大多数(60.31%)属于社会经济地位较低的人群。大多数患者的症状持续时间少于 6 个月(61.36%),来自 5 人或 5 人以上的家庭(85.48%)。吸毒史(78.45%)和原有并发症(65.75%)普遍存在。值得注意的是,在血清维生素 D 水平与人口统计学因素之间没有发现明显的关联。在就业者中,失业者占很大比例(31.97%),这凸显了社会经济方面的挑战。这些发现全面揭示了椎间盘退变的多面性,对于制定有针对性的干预措施和管理策略至关重要。
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